Department of Urology, University of Illinois College of Medicine, Chicago, Illinois.
Department of Urology, Queen's University, Kingston, Ontario, Canada.
J Urol. 2021 Mar;205(3):755-760. doi: 10.1097/JU.0000000000001407. Epub 2020 Oct 20.
We investigated whether baseline acute or chronic prostate inflammation among men with initial negative biopsies for prostate cancer was associated with cancer grade in 2-year repeat biopsies.
Retrospective analyses were conducted of 889 men aged 50 to 75 years old with negative baseline prostate biopsy and 2-year repeat biopsy positive for prostate cancer in the Reduction by Dutasteride of Prostate Cancer Events (REDUCE) study. Acute and chronic prostate inflammation and cancer grade were determined by central pathology during the REDUCE study. The association of inflammation in baseline and 2-year repeat biopsy and prostate cancer grade in 2-year repeat biopsy was evaluated with Student's t-test, chi-squared test and multivariable logistic regression.
Chronic, acute inflammation and both were detected in 533 (60%), 12 (1%) and 85 (10%) baseline biopsies, respectively. Presence of acute and chronic inflammation were significantly associated with each other (p <0.001). Both types of inflammation were unrelated to race, body mass index, prostate specific antigen or digital rectal exam. At the 2-year biopsy, 621 (70%) tumors were low grade (Gleason scores 2-6) and 268 (30%) were high grade (Gleason scores 7-10). In univariable and multivariable analyses, men with baseline chronic inflammation had significantly fewer high grade tumors (univariable OR 0.64, 95% CI 0.47-0.87, p=0.004; multivariable OR=0.68, 95% CI0.50-0.93, p=0.016) than those without baseline chronic inflammation. Baseline acute inflammation was not associated with tumor grade (univariable OR 0.74, 95% CI 0.45-1.20, p=0.22; multivariable OR 0.78, 95% CI 0.48-1.29, p=0.34).
Chronic inflammation in a negative biopsy was associated with lower prostate cancer grade among men with cancer on follow-up 2-year biopsy.
我们研究了在初始前列腺癌阴性活检的男性中，基线时的急性或慢性前列腺炎症是否与 2 年重复活检中的癌症分级相关。
对 REDUCE 研究中 889 名年龄在 50 至 75 岁之间、基线前列腺活检阴性且 2 年重复活检前列腺癌阳性的男性进行了回顾性分析。在 REDUCE 研究中，通过中心病理学确定急性和慢性前列腺炎症以及癌症分级。使用学生 t 检验、卡方检验和多变量逻辑回归评估基线和 2 年重复活检中的炎症与 2 年重复活检中前列腺癌分级之间的关系。
基线活检中分别有 533 例（60%）、12 例（1%）和 85 例（10%）检测到慢性、急性炎症和两者均有。急性和慢性炎症的存在显著相关（p<0.001）。两种类型的炎症均与种族、体重指数、前列腺特异性抗原或直肠指检无关。在 2 年的活检中，621 例（70%）肿瘤为低级别（Gleason 评分 2-6），268 例（30%）为高级别（Gleason 评分 7-10）。在单变量和多变量分析中，基线慢性炎症的男性高级别肿瘤明显较少（单变量 OR 0.64，95%CI 0.47-0.87，p=0.004；多变量 OR=0.68，95%CI0.50-0.93，p=0.016）。基线急性炎症与肿瘤分级无关（单变量 OR 0.74，95%CI 0.45-1.20，p=0.22；多变量 OR 0.78，95%CI 0.48-1.29，p=0.34）。
在随访 2 年重复活检中患有癌症的男性中，阴性活检中的慢性炎症与前列腺癌分级较低相关。
